Effect of phenytoin on bone and vitamin D metabolism.

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Bell RD, Pak CY, Zerwekh J, Barilla DE, Vasko M

Effect of phenytoin on bone and vitamin D metabolism.

Ann Neurol. 1979 Apr;5(4):374-8.

PubMed ID

220903 [ View in PubMed

]

Abstract

Calcium and vitamin D metabolism were evaluated in 5 adult epileptic patients before and during treatment with phenytoin. Significant decreases occurred in serum concentrations of calcium, albumin, and 25-hydroxy-cholecalciferol. The decreases in serum calcium paralleled those in serum albumin. Significant increases occurred in serum alkaline phosphatase and 1 alpha, 25-dihydroxycholecalciferol, in urinary hydroxyproline, and in the fractional gastrointestinal absorption of calcium. Urinary cyclic adenosine monophosphate and serum parathyroid hormone did not change. The results suggest that the bone disease resulting from phenytoin therapy may be associated with a deficiency of 25-hydroxycholecalciferol and not of 1 alpha, 25-dihydroxycholecalciferol, and that reduced gastrointestinal absorption of calcium or changes in parathyroid function may not be necessary for the development of bone disease.

DrugBank Data that Cites this Article

Drug Interactions

• Approved
• Vet approved
• Nutraceutical
• Illicit
• Withdrawn
• Investigational
• Experimental
• All Drugs

Drugs	Interaction
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Fosphenytoin Ethoxzolamide	The risk or severity of osteomalacia can be increased when Ethoxzolamide is combined with Fosphenytoin.
Fosphenytoin Diclofenamide	The risk or severity of osteomalacia can be increased when Diclofenamide is combined with Fosphenytoin.
Fosphenytoin Methazolamide	The risk or severity of osteomalacia can be increased when Methazolamide is combined with Fosphenytoin.
Phenytoin Ethoxzolamide	The risk or severity of osteomalacia can be increased when Ethoxzolamide is combined with Phenytoin.
Phenytoin Diclofenamide	The risk or severity of osteomalacia can be increased when Diclofenamide is combined with Phenytoin.

Pharmaco-metabolomics

Drug	Drug Groups	Metabolite	Change	Description
Phenytoin	Approved Vet Approved	25-hydroxycholecalciferol	decreased	Phenytoin decreases the level of 25-hydroxycholecalciferol in the blood
Phenytoin	Approved Vet Approved	Calcium	decreased	Phenytoin decreases the level of Calcium in the blood
Phenytoin	Approved Vet Approved	Calcifediol	decreased	Phenytoin decreases the level of Calcifediol in the blood